Health Care Reform-1/1/11 Flex change

[lillygator]

Sense of humor is not your friend, is it?

obviously not!

 

[Mandychelle79]

Really its no different then if you are in the hospital or nursing home. The doctors there write scripts all the time for OTC meds.

 

[Piecey]

Really its no different then if you are in the hospital or nursing home. The doctors there write scripts all the time for OTC meds.

I thought that was because someone else is giving it to the person, though?

Obviously after my c-section I wasn't going to drive to CVS to get some benadryl for myself, the nurses had to give it to me. I thought the doctor "ordering" the meds was more about liability because you're not giving it to yourself like you do with traditional OTC meds.

 

[LoraJ]

Do you lose what you don't spend in your accounts? Or does it carry over the following year?

 

[wvjules]

Really its no different then if you are in the hospital or nursing home. The doctors there write scripts all the time for OTC meds.

But you are not in a hospital or nursing home. You are, presumably, a healthy individual that has some phlem and need some musinex. Why waste my, or the doctor's time, getting an appointment so he can write "take mucinex" so it can be reimbursed by my HSA?

sbell, I was injecting some humor that's all. Its a Monday afternoon. I know I could use a laugh.

 

[PatsMom]

Really its no different then if you are in the hospital or nursing home. The doctors there write scripts all the time for OTC meds.

Perhaps that is why the OTC meds end up costing so much if you receive them in the hospital!

According to an article I just read on NPR since this thread got me curious, the CBO anticipated that between eliminating (or making difficult) coverage for OTC drugs and lowering the eligible amount from $5,000 to $2,500, they will save $18 billion over the next 10 years. Sure sounds like a tax increase to me. But the reason they give for lowering the cap is that people will have fewer out of pocket expenses as the government provides them with better health care alternatives. And they also argue that the OTC drugs lead to unnecessary expense at the end of the year when people buy stuff just to use up their unspent balances. I can remember my mother, who had an FSA, buying eyeglasses at the end of the year to make sure she used up her money so I guess there could be some merit to that.

But how is needing a script going to stop that? I could have my husband's doctor write a script for the entire next year's supply of CoQ10 for my husband - I could spend a lot of money on that one! Of course, they would want to see him first.

 

[Lisa loves Pooh]

I thought that was because someone else is giving it to the person, though?

Obviously after my c-section I wasn't going to drive to CVS to get some benadryl for myself, the nurses had to give it to me. I thought the doctor "ordering" the meds was more about liability because you're not giving it to yourself like you do with traditional OTC meds.

That is my understanding.

Especially due to drug interactions---

So seriously--there is effort to obtain an OTC script. But as someone posted, most won't bother--there is now an increased tax burden and voila--those pennies add up.

 

[DisneyCowgirl]

I want some real information on this because I use my FSA like crazy for OTC drugs and supplies one of my immediate family members needs for a medical condition.

Will I have to get an actual prescription or will a letter of medical necessity be sufficient? Where can I find out more about this? I googled, but didn't find what I was looking for.

 

[sbell111]

And I believe you are exaggerating the reasons for the change (fraud!) and overstating the simplicity as though it is a non-issue.

Actually, I'm doing neither. I merely gave another reason for the change and voiced my doubt that the new process will be as onerous as some argue.

Do you lose what you don't spend in your accounts? Or does it carry over the following year?

Yes, you lose what you don't use.

 

[kellyw8863]

I want some real information on this because I use my FSA like crazy for OTC drugs and supplies one of my immediate family members needs for a medical condition.

Will I have to get an actual prescription or will a letter of medical necessity be sufficient? Where can I find out more about this? I googled, but didn't find what I was looking for.

We get many OTC meds covered for my daughter under a catastrophic illness plan, and really, it's not that big of a deal. For things like CoQ10, levocarnitine, creatine, and omeprazole where the doses are largely weight dependant, her doc writes the script out for 6 refills (we have to see him every three months). For things like her dulcolax, miralax, Pedialyte, gauze, medical tape, etc. her doc writes out the script for 12 refills. And I can honestly say that I have never had to take her in office for innocuous OTC meds like the Pedialyte - it's always done over the phone without a visit, and her doctor's office faxes the script directly to her HHC. So I'm not sure that a letter of medical necessity would do it, but I would think a single script with 12 refills should suffice.

I guess I just don't see what the big deal is since it is something that we have always had to do in order to get these things covered. And, while it may not eliminate fraudulent claims, I would think that it would at least reduce them.

 

[sbell111]

It should be noted that being able to use FSA dollars for OTC drugs is a benefit that was added not so long ago. As such, it should come as no surprise that it is being tweaked.

 

[sbell111]

Perhaps that is why the OTC meds end up costing so much if you receive them in the hospital!

According to an article I just read on NPR since this thread got me curious, the CBO anticipated that between eliminating (or making difficult) coverage for OTC drugs and lowering the eligible amount from $5,000 to $2,500, they will save $18 billion over the next 10 years. Sure sounds like a tax increase to me. ...

I'd love to discuss this issue, but it would be political in nature and isn't allowed.

 

[PatsMom]

I'd love to discuss this issue, but it would be political in nature and isn't allowed.

I am trying to stay non-political. That is why I didn't quote anything from some web sites that I read. I thought NPR was fairly neutral. And as I've said, I am really not affected since I don't have an FSA available to me. I just don't like the spin put on this - it is to prevent fraud and abuse when it is really not, it is to keep the bill revenue neutral.

 

[LoraJ]

Actually, I'm doing neither. I merely gave another reason for the change and voiced my doubt that the new process will be as onerous as some argue.

Yes, you lose what you don't use.

That's a shame. I think we have different types of accounts, some carry over and some don't.

 

[Mickeyluver37]

Do you lose what you don't spend in your accounts? Or does it carry over the following year?

HSA's carry over, FSA's do not.

 

[Mandychelle79]

I thought that was because someone else is giving it to the person, though?

Obviously after my c-section I wasn't going to drive to CVS to get some benadryl for myself, the nurses had to give it to me. I thought the doctor "ordering" the meds was more about liability because you're not giving it to yourself like you do with traditional OTC meds.

Nope, even if the patient can self medicate there has to be an order for it.

 

[LoraJ]

HSA's carry over, FSA's do not.

Thanks. This was the first year we had to choose some kind of account. I guess mine is an HRA plus the stuff I put in the FSA, which I know I will spend every penny of. I was getting confused with the HSA.

Do HSA's have any pre-tax benefits? I cannot find the sheet they gave us when choosing different options.

 

[sparklynails23]

CoQ10 and fish oil? I don't see why supplements and vitamins should be paid with pre-tax income. Those are not medications.

 

[Scurvy]

CoQ10 and fish oil? I don't see why supplements and vitamins should be paid with pre-tax income. Those are not medications.

My opthamologist advised me to take fish oil or flax seed oil because of my extremely dry eyes. There are other synthetic medications that she could have prescribed but she prefers not to unless absolutely necessary. They tend to have side effects she'd rather her patients avoid. In my case, the oil is a medication. I ought to be able to use my FSA to pay for that just as I would if she prescibed a different med for dry eyes. My mother has to take OTC Vitamin D and calcium because her doctor has instructed her to. I even know someone who was prescibed a certain light box and ordered to use it for some amount of time each day. Certainly light isn't typically considered a medication, but because it is medically necessary for that person it is a medication in her case. I imagine that there are many other people who take other supplements and vitamins or use things like special lights on the recommendations of their doctors. Maybe some people who take them don't really need them, but that doesn't mean that they aren't medically necessary for other people. In many cases, those things are medications.

 

[kellyw8863]

CoQ10 and fish oil? I don't see why supplements and vitamins should be paid with pre-tax income. Those are not medications.

Not true. My daughter has mitochondrial disease and as such, the only treatment for it is with cofactors and enzymes. She takes CoQ10, levocarnitine, creatine monohydrate, and alpha-lipoic acid to combat the progression of her disease and improve cell function. These are medications that are prescribed by her metabolic specialist who is also one of the leaders in the country for treating children with mito and other metabolic diseases. Here in MA, health insurance companies are required by law to cover these medications providing they are prescribed by a doctor. There is no way we could afford it without insurance coverage and since there is no other treatment nor cure for mito, it is the best shot we have at beating the admittedly poor odds.